Benign Paroxysmal Positional Vertigo After Pediatric Sports-Related Concussion
Karen Reimer1,2,3,4, Vanessa Ellis1, Dean M Cordingley1,4
1Pan Am Concussion Program, Pan Am Clinic, Winnipeg, MB, Canada.
Insights
Pediatric patients with sports-related concussion (SRC) and benign paroxysmal positional vertigo (BPPV) experienced symptom resolution with particle repositioning (PR). This targeted treatment is effective for BPPV in young concussion patients.
Area of Science:
- Pediatric neurology
- Vestibular disorders
- Sports medicine
Background:
- Sports-related concussion (SRC) can present with complex symptoms.
- Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder that can coexist with SRC.
- Multidisciplinary management is crucial for pediatric concussion recovery.
Purpose of the Study:
- To report clinical findings and outcomes of pediatric patients with SRC and BPPV.
- To evaluate the effectiveness of particle repositioning (PR) for BPPV in this population.
Main Methods:
- Retrospective case series design.
- Inclusion of pediatric patients (<19 years) diagnosed with SRC and referred for vestibular physiotherapy.
- Diagnosis of BPPV and treatment with targeted PR maneuvers.
Main Results:
- 12 out of 115 (10.4%) pediatric SRC patients were diagnosed with BPPV.
- Posterior semicircular canal BPPV was most common (75%), followed by anterior SCC BPPV (25%).
- All patients achieved symptom resolution with an average of 1.58 PR maneuvers.
Conclusions:
- Pediatric SRC management requires a multidisciplinary approach.
- Targeted PR is an effective treatment for BPPV in pediatric SRC patients.
- Consideration of BPPV in persistent postconcussion symptoms is recommended.
Objective:
Report the clinical findings and outcomes among pediatric patients diagnosed with benign paroxysmal positional vertigo (BPPV) after sports-related concussion (SRC).
Design:
Retrospective case series.
Setting:
Multidisciplinary pediatric concussion program.
Patients:
Patients younger than 19 years with a sport or recreation activity-related concussion referred for comprehensive vestibular physiotherapy assessment.
Main Outcome Measure:
Symptom resolution after targeted particle repositioning (PR).
Results:
During the study period, 115 pediatric SRC patients underwent vestibular physiotherapy assessment including 12 (10.4%) who were diagnosed with BPPV. Unilateral posterior semicircular canal (SCC) BPPV was diagnosed in 8/12 (75%) patients, and unilateral anterior SCC BPPV diagnosed in 4/12 (25%) patients. Benign paroxysmal positional vertigo was successfully treated in all patients with a mean of 1.58 targeted PR maneuvers (range = 1-4).
Conclusions:
Comprehensive management of pediatric SRC requires a multidisciplinary approach to address the heterogeneous pathophysiology of persistent postconcussion symptoms. Pediatric SRC patients with coexisting BPPV should be considered for targeted PR.
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